Disordered Eating in College Athletes: Suggestions for Better Prevention and Treatment
Author: Kathryn Lodwick-Jones, LPC, BC-DMT, NCC
Studies show that 84% of college athletes have engaged in disordered eating patterns or weight control behaviors. They are also less likely to seek mental health support due to limited access to care, stigma, and sport-specific systemic barriers. This article will explore the prevalence of disordered eating in the student athlete population and discuss considerations and warning signs to look out for.
Prevalence and Risk Factors
Student athletes are at a higher risk for developing body image disruption, disordered eating patterns, or an eating disorder due to heightened pressures related to physical performance, specific and often rigid expectations to the physical and aesthetic appearance of the body (depending on sport), and increased stress. Although the prevalence of disordered eating in student-athletes varies by sport, gender, sex, and other factors, it is generally recognized as a significant issue within this community. Weight dependent sports such as wrestling, rowing, and rock climbing, or those with high cultural emphasis on appearance such as cheerleading, ballet, track, and figure skating are especially linked to higher rates of disordered eating as compared to sports where body weight is less of a focus. College athletes, as compared to high school athletes, often face higher performance expectations, which can be linked to scholarship retention, team success, and future professional opportunities. This creates more pressure to maintain certain body standards, especially in weight-dependent sports. Many college athletic programs offer more resources such as on-site nutritionists, sports psychologists, and mental health services. In spite of this, disordered eating can still be prevalent due to high levels of stress and competition. College athletes may have more independence and autonomy, as compared to high-school student aged athletes, but this also means they might make decisions around food and exercise that aren’t always in their best interest, particularly if they are struggling with mental health or body image issues.
Although disordered eating patterns are exhibited in both male and female athletes, studies indicate 62% of female athletes are impacted while only 33% of male athletes exhibit disordered eating patterns. Both males (77%) and females (80%) who participate in weight-dependent sports report engaging in compensatory behaviors, though female student-athletes face a higher risk compared to their male counterparts, with some studies indicating female athletes are up to twice as likely as male athletes to engage in disordered eating behaviors. Relationships significantly impact an athlete’s risk. Coaches, teammates, team culture, and media can reinforce pressures and contribute to maladaptive patterns, including restrictive dieting, and over-training impacting both physical and mental well-being of athletes. Disordered eating can lead to both short and long-term consequences including but not limited to: psychological impairment due to malnourishment, increased injury risk, hormonal disruption, stress, poor sleep, delayed recovery, impacts to performance, dehydration, menstrual cycle disruption, low energy, decreased bone density, dental problems, compromised immune functioning, gastrointestinal system disruption, and heightened risk for anxiety and depression.
Warning Signs and Symptoms
Athletes who struggle with disordered eating are up to 8 times more likely to be injured. Although 91% of coaches for college athletes state they have dealt with an athlete with disordered eating, only 27% of coaches feel confident in identifying the warning signs of an eating disorder. Common eating disorder symptoms can be overlooked and even normalized within the athletic environment due to toxic culture and normalized pressures. Although these systems may have been in place for decades, they are detrimental to the mental and physical well-being of athletes. They can have significant effects on their performance and potential mortality. It is also important to remember not every athlete will exhibit the same behaviors, but here are some warning signs to look out for to start:
- Drastic weight changes
- Significant shift in mood
- Decreased consumption of preferred foods
- Decreased eating around others
- Increased training outside of their norm
- Obsession with body image
- Unhealthy food rituals
Prevention and Support
Addressing disordered eating in student-athletes requires a multi-faceted approach that incorporates prevention, education, improved support systems, and professional intervention.
Below are some suggestions for colleges and coaches to work towards improved detection and prevention of eating disorders and ways they can support athletes who may be struggling or at increased risk.
Screening and Detection: Regular screening for disordered eating behaviors and mental health issues can help identify athletes at risk before the situation escalates. Colleges can provide evidence-based training to prepare coaches, athletic trainers, and teammates on how to recognize early warning signs.
Provide Access to Professionals: Ensure athletes have access to mental health professionals, dietitians, and other healthcare providers who are familiar with the needs of student-athletes. Early referral to mental health treatment can help mitigate more serious health consequences. Coaches, trainers, and health professionals play a significant role in prevention and providing support. Resources can include counseling services, hotlines, support groups,an on-staff registered dietitian, or collaboration with a student health center. Promote counseling services that focus on both performance psychology and mental health. This can include group therapy, one-on-one sessions, or workshops that address coping mechanisms, self-esteem, and body image, and eating disorder prevention.
Provide Education and Change the Culture: Working towards prevention, or at least reducing the risk of disordered eating, by fostering an environment focused on positive body image, providing nutritional education and support, and encouraging open conversations about mental health can be a great start. Encourage athletes to appreciate different body types and emphasize strength and health over appearance. Work to address stress and performance anxiety to reduce stigma, and support coaches, parents, and teammates to avoid the often reinforced idea that only one body type is suitable for success in a given sport. Encourage athletes to talk openly about body image concerns without fear of judgment or stigmatization, and normalize open discussion about body image without fear of being penalized or judged. Integrate dietetics and sports psychology by involving dietitians and sports psychologists in team settings to educate athletes on the right nutrition to support their performance goals and mental well-being. Coaches should prioritize overall wellness, not just performance goals. This includes ensuring athletes are getting enough rest, sleep, and time for recovery and reducing overtraining and weight-based performance goals. Instead of focusing on weight or appearance, coaches should emphasize skill development, strength, and improvement in athletic performance.
Develop Policies and Programs for Prevention: Institutions should create clear team guidelines and policies that define healthy eating behaviors, discourage harmful weight control practices, and outline how to seek help for eating disorders. Holistic health programs focused on the discussion of mental health, body image, and proper nutrition as a part of the athletic culture can foster community based support. Foster open communication with all stakeholders including caregivers, coaches, and athletes. Involve athlete’s families by informing them about the importance of a healthy relationship with food and exercise. Engaging parents can help provide additional support for the athlete’s well-being outside of the competitive environment. Encourage coaches to be positive role models focused on demonstrating how to maintain balance between athletic training and self-care. By combining education, mental health support, a focus on overall wellness, and the proper resources, disordered eating in student-athletes can be prevented and addressed in a way that promotes long-term health, performance, and well-being.
Equilibria is a group of licensed mental health professionals in Pennsylvania and New Jersey with multiple specialties to serve all aspects of our diverse community’s mental, emotional, and behavioral needs. We provide in person and telehealth services to individuals of all ages, families, and those in relationships. Click here to schedule an appointment today.
